Part – 2

Prescribed Forms / Annexure

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 Annexure 1
Covering letter format
(On the letter head)

To
Executive Enginner,
Ujjain Development Authority (UDA),
7, Race Course Road,
Ujjain (M.P.) Pin – 452003
Phone : +91-0731-2430553

Sub: “Request for Proposal (RFP) for Empanelment of Consultants and Architects for various works of
UDA”.

Having examined all the details given in RFP document and Pro-forma for the above Consultancy &
Architectural works, I/we hereby submit the relevant information.

1. I / We hereby certify that all the statements made and information furnished in the enclosures is true
and correct.

2. I / We have furnished all information and details necessary for RFP and have no further pertinent
information to supply.

3. I / We also agree that the EE UDA , Ujjain or their authorized representatives can approach individuals,
employers and firms to verify our competence and general reputation.

4. I / We submit certificates in support of our suitability, technical knowhow and capability for having
successfully completed the projects, in prescribed format.

5. I / We agree that the discretion and decision of the UDA , Ujjain in respect of the Empanelment of the
Consultants and Architects is final and binding.

Date Signature(s) of Applicant(s) with seal

Enclosures:
1.
2.
Etc.

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 Annexure 2
Application Form for Empanelment

Sl. No. Particulars Details

1. Name of Organization
2. Address
3. Contact Person
4. Telephone No.
5. Mobile No.
6. Fax No.
7. E-mail ID
8. Organization Details To be filled as per
Annexure 3
9. Details of Directors/Partners/Proprietors To be filled as per
Annexure 4
10. List of Projects/ Consultancy Assignments Completed in Last To be filled as per
7 Years Annexure 5

11. Details of Projects/ Consultancy Assignments Completed in To be filled as per

Last 7 Years Annexure 6

12. Financial Status To be filled as per

Annexure 7
13. Checklist of Categories Applied for by the Bidder To be filled as per
Annexure 8
14. List of equipments available with the firm To be filled as per
Annexure 9
15. Litigation/ Arbitration To be filled as per
Annexure 10
16. Affidavit To be filled as per
Annexure 11

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 Annexure 3
Organizational Details
Sl. No. Parameter Details
1. Organizational Set-up:

• Place of Incorporation

• Year of Establishment/
Incorporation/ Registration

• Status of Firm
(Proprietorship/Partnership/Limited/Any other)

• Name of Directors/Partners/Proprietors

• Empanelment with Govt. Organizations

(Mention names along with copies of Certificates)

2. Employee Strength: Mention Details Here

• Principal Architects (mention nos. here)

• Junior Architects (mention nos. here)

• Urban Planner (mention nos. here)

• Interior Designers (mention nos. here)

• Civil Engineers (mention nos. here)

• MEP Engineers (mention nos. here)

• Infrastructure Planning/Engineering Specialist

• Mapping & AutoCAD/GIS Specialist

3. Details of Office:
4. Outsourcing jobs :
• Structural Design
• Plumbing, Sanitary & Water Supply
• MEP services. /
• Fire Fighting/Detection System
• Any Other
Place : Signature of the Applicant

Name & Designation

Date :

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 Annexure 4
Details of Directors /Partners /Proprietors

Sl. No. Name of Partners Academic Designation Address/

/Directors/Proprietors Qualifications Phone/Fax /e Mail

Signature of the Applicant

Name & Designation

Place :

Date :

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 Annexure 5
List of Projects/ Consultancy Assignments Completed in Last 7 Years

Category for which RFP is submitted:

Project Start Project
SN Name of the Project Client Date Completion date Remarks

Note :

1. Only completed projects in last 7 years, relevant to application category, shall be included in the list
above.

Signature of the Applicant

Name & Designation

Place :

Date :

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 Annexure 6
Details of Projects/ Consultancy Assignments Completed in Last 7 Years

Category: [insert similar assignment category as specified under Eligibility and evaluation criteria
mentioned in clause 3.1 and 5.2]

Assignment Name: Value of the contract (in current INR):

Country: Duration of assignment (months):

Name of City/ Cities:

Name of Client: Total No of staff-months of the assignment:

Address of client (along with Contact details, mail id of concerned person):

Start date (month/year):

Completion date (month/year):

Narrative description of Project:

Description of actual services provided by your staff in the assignment:

Note:

1. The details of Works/Projects mentioned above should be substantiated with documentary evidence such
as Work Orders/Contract Agreements.
2. Applications received without necessary documentary evidence are liable to be rejected.
3. Separate Annexure 6 should be submitted for each category Bidder has applied for demonstrating similar
projects of that category.

Signature of the Applicant

Name & Designation

Place :

Date :

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 Annexure 7
Financial Status

Turnover
Sl. No. Financial Year Profit/Loss(-) (Rs.)
(Consultancy Fee) (Rs.)
1 2018-19

2 2019-20

3 2020-21

Total --

Average --

Note:

1. Certified copies of audited Balance Sheets/Chartered Accountants Certificates to be enclosed.

Signature of the Applicant

Name & Designation

Place :

Date :

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 Annexure 8
Checklist of Categories Applied for by the Bidder

Tick (√) if Applied

Category
Sl. No. Sub Category A Sub Category
B
1. Category: General Architectural Services including
Designing, Planning, Detailed Project Report (DPR), Bid
Process Management for all type of Building Projects
including but not limited to Residential, Commercial, Govt
Offices, Industrial, Health & Education Facilities (IT
Parks/Offices), Auditoriums & Conservation centers, Sports
Complex, Clubs and Recreational Complex, Transport
Facilities (bus stations, terminals, parking, logistic hubs etc)
etc

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 Annexure 9
List of Equipments Available With the Firm

Sl. No. Name of Type Nos.

Equipment

1. Computers
2. Printers
3. Plotters
4. Software’s

Signature of the Applicant

Name & Designation

Place :

Date :

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 Annexure 10
Litigation/Arbitration

Year Contract Identification and Matter in Dispute Value of Pending Claim in INR
or any other currency
Contract Name :

Name of Employer :

Address of Employer :

Matter in Dispute :

Total value of the Contract :

Contract Name :

Name of Employer :

Address of Employer :

Matter in Dispute :

Total value of the Contract :

Contract Name :

Name of Employer :

Address of Employer :

Matter in Dispute :

Total value of the Contract :

Signature of the Applicant

Name & Designation

Place :

Date :

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 Annexure 11
Affidavit

(TO BE SUBMITTED ON NON-JUDICIAL STAMP PAPER OF MINIMUM Rs.100/- DULY CERTIFIED BY NOTARY)

Affidavit of Mr. ……………………………………….S/o …………………………………..

R/o……………………………………..……………………………………………………….

I, the deponent above named do hereby solemnly affirm and declare as under:

1. That I am the Proprietor / Authorized signatory of M/s. ……………………having its Head Office /Regd.
Office at ……………………………

2. That the information / documents / Experience certificate(s) submitted by

M/s…………..along with this ‘Request for Proposal for Empanelment of Consultants and Architects’ to
Ujjain Development Authority, Ujjain are genuine and true and nothing has been concealed.

3. I shall have no objection in case Ujjain Development Authority, Ujjain verifies them from issuing
authority(s). I shall also have no objection in producing the original copy of the document(s), in
case Ujjain Development Authority, Ujjain demand so for verification.

4. I hereby confirm that in case, any document, information & /or certificate submitted by me is found to be
incorrect/false/fabricated, Ujjain Development Authority, Ujjain at its discretion may disqualify / reject
my application for pre-qualification out rightly and also debar me /M/s.……………….from
participating in any future tenders/RFPs.

Deponent

I, ……………., the Proprietor / Authorized signatory of M/s. ………………, do herby confirm that the contents of the
above Affidavit are true to my knowledge and nothing has been concealed there from and that no part of it is
false.

Verified at ………………this ………….day of ………………..

Deponent

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 Annexure 12

JOINT VENTURE (J.V.)

If J.V. is allowed following conditions and requirements must be fulfilled:

Bids submitted by a joint venture of two or more firms as partners shall comply with the following requirements:
a. one of the partners shall be nominated as being Lead Partner, and this authorization shall be
evidenced by submitting a power of attorney signed by legally authorized signatories of all the
partners;
b. the bid and, in case of a successful bid, the Agreement, shall be signed so as to be legally binding on all
partners;
c. the partner in charge shall be authorized to incur liabilities and receive instructions for and on behalf
of any and all partners of the joint venture and the entire execution of the contract, including
payment, shall be done exclusively with the partner in charge;
d. all partners of the joint venture shall be liable jointly and severally for the execution of the contract in
accordance with the contract terms, and a statement to this effect shall be included in the
authorization mentioned under [c] above, as well as in the bid and in the Agreement [in case of a
successful bid];
e. The joint venture agreement should indicate precisely the role of all members of JV in respect of
planning, design, construction equipment, key personnel, work execution, and financing of the project.
All members of JV should have active participation in execution during the currency of the contract.
This should not be varied/modified subsequently without prior approval of the employer;
f. The joint venture agreement should be registered, so as to be legally valid and binding on all partners; and
g. a copy of the Joint Venture Agreement entered into by the partners shall be submitted with the bit!.
.
2. The figures for each of the partners of a joint venture shall be added together to determine the
Bidder's compliance with the minimum qualifying criteria required for the bid. All the partners
collectively must meet the criteria specified in full. Failure to comply with this requirement will result
in rejection of the joint venture's bid.
3. The performance security of a Joint Venture shall be in the name of the
partner
Lead Partner/joint venture.
4. Attach the power of attorney of the partners authorizing the Bid signatory(ies) on behalf of the joint venture
5. Attach the agreement among all partners of the joint venture [and which is legally binding on all
partners], which shows the requirements as indicated in the Instructions to Bidders'.
6. Furnish details of participation p1oposedin the joint venture as below:
DETAILS OF PARTICIPATION IN THE JOINT VENTURE

PARTICIPATION DETAILS FIRM”A” (lead FIRM”B” FIRM”C”

Partner)
Financial
Planning
Construction Equipment
Key personnel
Execution of Work
(give details on contribution of each)

For the purpose of evaluation of technical bids, it is hereby clarified that in addition to the conditions
contained above the partners of JV should satisfy the qualification criteria as below -
a. The lead partner must have a share minimum of 51% in the JV.
b. The other partner(s) must have a share of minimum 26% in the JV.
c. The lead partner and the other partners must also meet 51% and 26% of the all qualifications
criteria respectively except for the requirement of work experience described. However both the
partners must satisfy the full 100% qualification criteria jointly. For this purpose the qualification
ofindividual partners shall be added (for Annual Average Turnover and for Bid Capacity only).

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 UJJAIN DEVELOPMENT AUTHORITY,
Bharatpuri Administrative Zone, Dewas Road
UJJAIN (M.P.) Pin - 456010

Annexure – A

|| AFFIDAVIT ||
(On Non Judicial Stamp of Rs. 50/-)

I/We _____________________________who is/ are________________

(status in the firm/ company) and competent for submission of the affidavit on behalf of
M/S ______________________ (contractor) do solemnly affirm on oath and state that:
I/We am/are fully satisfied for the correctness of the certificates/records submitted in
support of the following information in bid documents which are being submitted in
response to notice inviting e-tender No. ______________ for
__________________________ (name of work) dated _______ issued by the Executive
Engineer, UDA Ujjain.
I/We am/ are fully responsible for the correctness of following self-certified information/
documents and certificates:
1. That the self-certified information given in the bid document is fully true and authentic.
2. That:
a. Term deposit receipt deposited as earnest money, demand draft for cost of bid
document and other relevant documents provided by the Bank are authentic.
b. Information regarding financial qualification and annual turnover is correct.
c. Information regarding various technical qualifications is correct.
3. No close relative of the undersigned and our firm/company is working in the
department.
OR
Following close relatives are working in the department:
4. We undertake that we never got black listed in any department

Name _______________ Post ____________ Present Posting________

Signature with Seal of the Deponent (bidder)

I/We, _____________________ above deponent do hereby certify that the facts

mentioned in above paras 1 to 3 are correct to the best of my knowledge and belief.

Verified today _____________ (dated) at ______________ (place).

Signature with Seal of the Deponent (bidder)

Note: Affidavit duly notarized in original shall reach at least one calendar day before opening of the

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